Broker's View: Efficient Claim Processing System

1. A Broker, Managing Agent and Xchanging View 360

2. Broker View Brokers use many different batch systems to process claims data electronically. The following screenshots are from Interactive CLASS – highlighting ECF related fields and any other fields that will assist the smooth flow of the agreement process. All screens are populated with test data for demo purposes only. It should be best practice to populate all fields with accurate data and to use narrative fields fully. All Brokers should aim for a “right first time” approach to enable benefit all parties involved on the claim transaction. *Screen shots relate to CLASS and DMS entry

3. User enters basic claim details in the CLASS CLAIM ENTRY screen and presses ENTER to continue to the CLASS DETAILS screen.

4. Where the Bureau for the transactions is Lloyd’s, the UNCLOSED POLICY flag is disabled and defaulted to ‘N’, thus automatically enforcing the provision of an OSND on all online Lloyd’s transactions.

5. The system checks whether an advice for the UMR has previously been released, and if so, whether the UMR entered is the same as the UMR for the previously released advice. UMR must be the same as on previously released advice B08532345670

6. The new Document Summary screen, showing the user a list of any risk or claim documents already uploaded for the claim. Click here To add a new document, the user clicks either the ‘Add Risk Docs’ or ‘Add Claim Docs’ pushbutton.

7. The Claim Document Upload screen is displayed. Click here The list of documents selected for upload is initially empty and the user must browse to find the file(s) that they wish to upload using the Browse option.

8. The browse files dialogue box is displayed, allowing the user to select one or more files for upload. Click here After selecting one or more* files for upload, selecting the Open option returns the user to the Document Upload screen with the selected file(s) displayed. NB: ADOBE Flash should be pre-installed on the workstation, to enable selection of multiple files at this stage.

9. The selected files are displayed in the list. Click the waste basket icon to remove any unwanted files In this case, an email file (.msg or .eml file format) has been selected for upload, and the email contains a number of attachments. These are automatically separated out from the email for upload as individual files. Prior to uploading the selected file(s), the necessary file information must be entered by the user. In the case of email files and the separated attachments, the information only needs to be entered for the email and it will be automatically set against the attachments upon upload..

10. Click here After completing the required document information, selecting the Upload option uploads the files to the repository and re-displays the Document Summary screen showing the uploaded files.

11. The Document Summary is displayed showing the newly uploaded files. To return back to CLASS and successfully release the transaction after completing claim data entry, the ‘Presentation of Claim File is Complete’ checkbox needs to be ticked, and then the Continue option selected.

12. Click here If the checkbox is not selected, the user can still select to ‘Continue’ and complete claim data entry but the transaction cannot be released.

13. The user is now returned to CLASS where the POLICY DETAILS screen is shown. The user enters the relevant details and continues through until the SIGNING DETAILS screen is reached.

14. The user does not enter a signing for the transaction and continues through until they reach the CONFIRMATION screen.

15. Because the UNCLOSED POLICY flag was automatically defaulted to ‘N’ and disabled when the user entered the basic claim details, and an OSND was not entered by the user at the SIGNING DETAILS screen, the transaction cannot be submitted/ released.

16. Once all validation errors have been addressed, the transaction can be released for processing. Note: DMS can also be manually invoked from this screen if documents need to be re-verified before the transaction is released.

17. Once released this is the route for a broker to enquire On-line

18. Standard Details

19. Broker On-Line view of responses Adjuster (Lloyds & ILU) comments are loaded here. Keep these concise as there are limited lines available. Be sure to add full name and contact details. Additional narrative can be added to a document and saved to the IMR. If a broker is re-releasing a transaction to resolve a query, add additional narrative to explain the purpose of the re-release to carriers

20. Use this button to link straight to a claim summary in the repository. This functionality only works if the CLASS user has a repository license. It will save a user having to log in twice and remembering two passwords.

21. Note – The broker view builds from CLASS. Therefore if the claim is across CLASS markets, this screen shows the Bureau lead of the last transaction released to CLASS. If for any reason a CLASS message is deleted on one version of CLASS but live on another version, the transaction tab will show DEL. The Helpdesk will need to reset the access control for remaining CLASS users to be able to view it. Select to add documents

22. Click on the + and a selection box opens and will allow you to choose documents to load. Multiple selections are allowed. The further actions below must be performed on all documents therefore you should highlight each in turn. This must be the date the document was created and is used to build a chronological view in DFV. When adding a document at TR level it will associate to the TR selected. Click create to load When adding a document to the ALL tab you will need to select the TR you wish to associate the document to.

23. Note the difference where the date is not completed on loading. The transaction is now ready for adjusters.

24. Managing Agent View – ECF2 The following screenshots are from ECF2 highlighting related fields from Claims Workflow Services (CWS), the Claims Agreements Screens (CAS) and Document File Viewer (DFV). All screens are supported by comments to allow you to navigate through the system with ease.

25. Click No. 1 – ‘’Allocate Claims’’ – Claims Workflow Services (CWS) - to view your pending work items in your work list or team list. This will only be available to your organisation if signed up to the CWS service. If you have not signed up for CWS and have your own workflow the option will not be available on this screen. Click No. 2 ‘’Review & Respond’’ – Claims Agreement Screens (CAS) - to respond to a claim / UCR or enquire on an actioned UCR. Click No. 3 - to view the Insurers Market Repository (IMR), this includes viewing all documents, the UMR (for policy information) and viewing and or responding to a claim via ECF.

26. If you click on No.1 ‘’Allocate Claims’’ – Claims Workflow Services (CWS) – the screen below is shown Each section is expanded to show you data populated within Claims Workflow Services (CWS) Non Agreement Party UCRs and relating TRs will be highlighted within this area to enable sight of financial movement prior to leads action and a message being generated to org systems.

27. When you click on the claim for you to review in the “Claims Awaiting Action“ section of CWS (see page above), the screen below is returned.

28. The ringed items below explain what they will return to you when you enquire on them.

29. DFV - The screen below is returned when you make your selection of documents to view from the hyperlink at the top of the page. The header will start with UCR for claim and UMR for policy documents. You can either scroll through using the arrows or you can click on the documents on the left hand side.

30. The left pane details the transaction showing the “Claim Details/Policy Details/Financial Details/Broker Comments” within tabs. The right pane allows your syndicate details, comments and relating response to be entered. See following screen shots for more detail on claim response.

32. Public and Private Comment areas have a 15 line restriction per bureau, per TR. 15 lines can easily be populated when multiple agreement parties are required to comment. If comments section is full please add your comments to a word document and load to the IMR and relating TR.

33. If you need to Query the transaction, click the Query radio button, you will be asked to enter a reason from the drop down list (on the next page). Click on the hyperlink for “Query Reason” and tick the box(es) as applicable. You can tick more than one, but not all.

35. This screen below is your confirmation that you agree that everything you have done is accurate. Click ‘’Confirm Response’’ if you agree or ‘’Cancel’’ if you wish to return to the previous screen.

36. These screens are the LIRMA Company response screens within ECF2. The lead LIRMA Company is requited to assign a Business Class / Claim Category & Sub Category from the drop downs provided. The lead LIRMA company then has the option to circulate to other LIRMA companies on the policy with their relating lead comments.

37. Once circulated and as LIRMA lead or a LIRMA follower, you will be required to add your contact name, details and comments to the relating TR. Your response can then be submitted and confirmed as CAA – Agreed / DIS – Disagree / INF – Information required / FIL – Information and file required is non ECF This response also enables you to confirm if further response is required on the next TR from your company. Please refer to the COB NFR rules set by your CLASS administrator.

38. This screen below is your confirmation that you agree that everything you have done is accurate. Click ‘’Confirm Response’’ if you agree or ‘’Cancel’’ if you wish to return to the previous screen.

39. If you click on No.2 - CAS (Claims Agreement Screens – ‘’Review and Respond’’) – the screen below is shown. On the Claim tab, please enter the UCR and you will be shown your requested claim within a hyperlink. You will need to click once on the “UCR (hyperlink)” to open the claim.

40. The screen below is returned when you click on the claim / UCR hyperlink as shown on the page above.

41. When you click on the Part Authorised option above, the screen below will be seen. This will include the response screen, as the transaction is “incomplete” (and still requires action).

43. Choose the transaction you wish to view and click once, (see above). As you can see the “Response” box below is now blank and to view the completed transaction, you need to click on the “View Market Response” button, this will then populate the “View Market Response” screen on the page below.

45. The Comments for all Transactions can be seen in Cross Market Comments screen, which you can view by clicking on the icon at the top of the Transaction screen. The comments for all transactions can be seen within the ‘’Cross Market Comments’’ screen, which you can view by clicking on the hyperlink at the top of the transaction screen. All historical comments by all responding parties can be viewed in one screen.

46. Managing Agent View – ECF The following screenshots are from ECF and the Insurers Market Repository (IMR). Highlighting related fields with supporting comments to allow you to navigate through the system with ease.

47. After logging in, this is the first page you will see. It allows you to search the IMR for claims or risks. It’s a good idea to always uncheck the ‘Exclude Closed Claims’ box when searching, as the claim you are looking for may be on a closing transaction and if this check box is ticked it will not include it in your search results.

48. This is a search which brings back a list of all claims awaiting completion on the IMR for the syndicates which you are authorised to access and for which you have an agreement party role. If the response code is blank in conjunction with a lead role then it requires your action before any other party can work on it. Once you have responded, the response code will be updated and the entry will remain on your ‘Awaiting Action’ list until all agreement parties have responded. Lloyds claims can only be searched for in this section and results can be filtered using the various fields in the search section.

49. Once you enter a particular claim this will be the first screen you come to. It allows you to raise an individual or organisational conflict if appropriate. It will take you to the following page if you register a conflict.

50. If you raise a conflict in error or the conflict no longer exists please contact the XIS helpdesk to have the conflict removed. If you raise an organisational conflict you will need to contact the broker and XCS to advise them of this conflict.